Abstract

Background Despite the rising childhood obesity rates, few studies have examined the association between access to recreational parks
and facilities and obesity.

Methods A cross-sectional study was performed among 42 278 US children who participated in the 2007 National Survey of Children's
Health. Access to parks and recreational facilities was self-reported by parents, and body mass index was calculated from
parents’ self-report of the child's height and weight. Logistic regression was used to obtain ORs and 95% CIs. Since obesity
was not a rare occurrence, an OR correction method was used to provide a more reliable estimate of the prevalence ratio (PR).

Results Children with access to parks and facilities had decreased prevalence of obesity as compared to children without access (PR=0.79,
95% CI 0.69 to 0.91). After adjustment for covariates, the magnitude of the association remained unchanged; however, results
were no longer statistically significant (PR=0.77, 95% CI 0.55 to 1.07). Race/ethnicity was an effect modifier of the access–obesity
relationship (p<0.0001). Among Non-Hispanic White children, there was no strong association (PR=0.89, 95% CI 0.64 to 1.23).
However, among Non-Hispanic Black children, those who had access to recreational parks and facilities had 0.40 times the prevalence
of obesity as compared to those without access, and this result was statistically significant (95% CI 0.17 to 0.90).

Conclusions This research highlights potential health disparities in childhood obesity due to limited access to recreational parks and
facilities. Additional studies are needed to further investigate this association. If confirmed, providing safe, accessible
parks and facilities may be one way to combat childhood obesity, particularly among minority children.